| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14,490 |
11,044 |
$901K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
6,329 |
4,223 |
$364K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,941 |
2,834 |
$243K |
| T1015 |
Clinic visit/encounter, all-inclusive |
14,542 |
11,197 |
$156K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,974 |
2,378 |
$132K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,408 |
1,070 |
$81K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,989 |
3,486 |
$77K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,667 |
5,179 |
$61K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
653 |
417 |
$35K |
| 90651 |
|
105 |
43 |
$2K |
| 95117 |
|
317 |
144 |
$2K |
| 99215 |
Prolong outpt/office vis |
30 |
28 |
$2K |
| 90734 |
|
155 |
53 |
$2K |
| 90710 |
|
200 |
102 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
29 |
26 |
$842.67 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
48 |
25 |
$591.07 |
| 90670 |
|
2,550 |
1,664 |
$478.24 |
| 90707 |
|
73 |
14 |
$342.62 |
| 90686 |
|
1,175 |
872 |
$326.37 |
| 90671 |
|
262 |
244 |
$197.96 |
| 90680 |
|
1,233 |
825 |
$177.51 |
| 90723 |
|
1,051 |
708 |
$139.60 |
| 90715 |
|
53 |
14 |
$116.76 |
| 90633 |
|
704 |
465 |
$102.40 |
| 90672 |
|
50 |
30 |
$96.43 |
| 90647 |
|
1,390 |
865 |
$55.31 |
| 90648 |
|
68 |
61 |
$20.83 |
| 90473 |
|
584 |
274 |
$8.00 |
| 90696 |
|
100 |
40 |
$0.00 |
| 90697 |
|
103 |
97 |
$0.00 |
| 90732 |
|
52 |
28 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,543 |
401 |
$0.00 |
| 90461 |
|
530 |
209 |
$0.00 |